Angiographic circulation time and cerebral blood flow during balloon test occlusion of the internal carotid artery

Kenichi Sato, Hiroaki Shimizu, Takashi Inoue, Miki Fujimura, Yasushi Matsumoto, Ryushi Kondo, Hidenori Endo, Yukihiko Sonoda, Teiji Tominaga

Research output: Contribution to journalArticlepeer-review

29 Citations (Scopus)


Angiography-based balloon test occlusion (BTO) has been empirically used to predict tolerance to permanent carotid artery occlusion. We tested the hypothesis that the laterality of the hemispheric circulation time (HCT) of the contrast medium at cerebral angiography would reflect bilateral asymmetry of the cerebral blood flow (CBF) during BTO. Thirty-one consecutive patients who underwent BTO of the internal carotid artery were retrospectively analyzed. HCT was defined as the interval between the time-to-peak in the middle cerebral artery and the cortical veins calculated using time-density curve. The difference in HCT between the occluded and nonoccluded side was calculated at the carotid or dominant vertebral angiograms obtained during BTO. We estimated the correlation between the difference in HCT and bilateral asymmetry of the CBF, which was quantitatively determined by single-photon emission computed tomography. The HCT was 5.3±1.5 seconds and regional CBF was 41.3±11.3 mL/100 g per minute in the occluded side, compared with 3.6±0.9 seconds and 48.4±14.9 mL/100 g per minute in the nonoccluded side, respectively. The difference in HCT was strongly correlated with the asymmetry ratio of the CBF (r2 =0.89, P<0.0001). Angiographically based measurement of the cerebral circulation time can provide valuable information concerning cerebral hemodynamics.

Original languageEnglish
Pages (from-to)136-143
Number of pages8
JournalJournal of Cerebral Blood Flow and Metabolism
Issue number1
Publication statusPublished - 2014 Jan


  • angiography
  • balloon test occlusion
  • carotid artery sacrifice
  • cerebral blood flow
  • circulation time

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology
  • Cardiology and Cardiovascular Medicine


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